Hematological problems in HIV infected children have never been studied in India. This study was thus undertaken to assess the hematological manifestations in HAART naive HIV-1 infected children.
Pediatric HIV Clinic at B.J.Wadia Hospital for Children, Mumbai
Prospective cross-sectional study.
Methods & Materials:
50 HIV infected children referred to our HIV Clinic over a period of 6 months in 2005 underwent a baseline hematological analysis. All patients underwent a through clinical examination and factors such as age, sex, growth, CD4 count, opportunistic infections and their association with various hematological manifestations were studied.
45 patients (90%) had elevated ESR, 35 patients (70%) had anemia, 14 patients (28%) had leucocytosis, 12 patients (24%) had lymphopenia, 5 patients (10%) had thrombocytopenia and 1 patient (2%) had leukopenia with neutropenia. Patients with lymphopenia had a mean age of 6.8+3.5 years Vs 4.7 + 2.1 years which was statistically significant (p = 0.01) whereas patients with thrombocytopenia had a mean age of 7.5 + 4.1 years Vs 5.0 + 2.3 years (p = 0.03) and patients with elevated ESR had a mean age of 4.9+ 2.3 years Vs 7.6 + 4.0 years (p = 0.03). All patients with anemia had microcytic hypochromic anemia. Thrombocytopenia was more common in patients with Tuberculosis in the past (p = 0.049). There was no correlation with lymphopenia and decrease in CD4 count (p=0.81) or CD4 percent (p=0.34). Growth parameters, sex, mode of transmission, immunological profile and opportunistic infections had no statistical association with hematological manifestations.
Hematological problems in HIV infected children in India are common. Elevated ESR and anemia are the commonest features. Elevated ESR may be used as a marker to screen a child for HIV infection. Microcytic hypochromic anemia is the commonest type of anemia seen.